Basic Information
Provider Information
NPI: 1659768505
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ABHYANKAR
FirstName: RAHUL
MiddleName: DILIP
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6983 HILLSDALE CT
Address2:  
City: INDIANAPOLIS
State: IN
PostalCode: 462502054
CountryCode: US
TelephoneNumber: 3178498350
FaxNumber: 3175766311
Practice Location
Address1: 12188A N MERIDIAN ST STE 320
Address2:  
City: CARMEL
State: IN
PostalCode: 460324407
CountryCode: US
TelephoneNumber: 3175800420
FaxNumber: 3175800451
Other Information
ProviderEnumerationDate: 04/17/2015
LastUpdateDate: 03/22/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/22/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0008X01082208AINN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular Medicine
2084N0400X01082208AINY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology

ID Information
IDTypeStateIssuerDescription
30003960105IN MEDICAID


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